Research article summary (published 29 Sep 2009):

Accuracy of cross-table lateral knee radiography for evaluation of joint effusions.

Full Abstract

OBJECTIVE: The purpose of our study was to investigate the efficacy of cross-table lateral knee radiography in the diagnosis of knee effusions compared with an MRI reference standard, to evaluate reader experience in effusion assessment, and to establish a new threshold for suprapatellar pouch measurement for the diagnosis of effusion. MATERIALS AND METHODS: First- and third-year radiology residents and an attending musculoskeletal radiologist retrospectively assessed 108 cross-table lateral knee radiographs for qualitative grading of joint fluid and quantitative measurement of the suprapatellar pouch. Qualitative and quantitative evaluation of ipsilateral knee MRI examinations performed within 1 week of radiography was performed by two attending musculoskeletal radiologists as a reference standard. RESULTS: Qualitative visual grading of cross-table lateral radiographs had a sensitivity of 90-92%, specificity of 39-54%, and accuracy of 69-76% for joint effusion. Extrapolating from previous work showing 4 mL of fluid distends the suprapatellar pouch to 4 mm on midline sagittal MRI, the corresponding measurement on cross-table lateral radiographs was predicted to be 7 mm. Using this new criterion of effusion, sensitivity, specificity, and accuracy compared with an MR midline sagittal reference standard were 76%, 83%, and 81%, respectively. Historical data for overhead lateral radiographs had a sensitivity of 78%, specificity of 80%, and accuracy of 79%. CONCLUSION: Qualitative visual assessment of cross-table lateral knee radiographs is highly sensitive for the detection of joint effusion. By performing quantitative evaluation with a new 7-mm criterion for suprapatellar pouch measurement, sensitivity, specificity, and accuracy are equivalent to that of overhead lateral radiography.

Author information

Author/s: Tai, Angela W (AW); Alparslan, Hatice L (HL); Townsend, Brent A (BA); Oei, Tamara N (TN); Govindarajulu, Usha S (US); Aliabadi, Piran (P); Weissman, Barbara N (BN);

Affiliation: Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115, USA. awtai(-atsign-)partners.org

Journal and publication information

Publication Type: Journal Article

Journal: AJR. American journal of roentgenology (AJR Am J Roentgenol), published in United States. (Language: eng)

Reference: 2009-Oct; vol 193 (issue 4) : pp W339-44

Dates: Created 2009/09/22; Completed 2009/10/14;

PMID: 19770305, status: MEDLINE (last retrieval date: 10/14/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Exudates and Transudates - cytology Female Humans Image Enhancement - methods Joint Diseases - diagnosis Knee Joint - pathology

Magnetic Resonance Imaging - methods Male Observer Variation Reproducibility of Results Sensitivity and Specificity Supine Position

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